Multistage Random Sampling Research Articles

Prevalence and factors associated with external HIV-related stigma in the South African population: Results from the 2017 population-based household survey.

External HIV-related stigma remains pervasive, and its effect debilitating among PLHIV in South Africa, even though the country has made many advances against HIV. External HIV-related stigma impedes both HIV prevention and access to health care and reduces the quality of treatment and care received. This study examined the prevalence of and factors associated with higher levels of HIV-related stigma among youth and adults 15 years and older in South Africa. The analysis used a nationally representative population-based household survey data collected using a multistage cluster random sampling design. Exploratory factor analysis was used to calculate the primary outcome (higher and lower HIV stigma index scores above and below the mean, respectively), based on the total number of factors retained from the 10 item self-reported questions relating to attitudes and beliefs against PLHIV. Bivariate and multivariate generalised linear models with a log link and binomial distribution were fitted to estimate crude and adjusted risk ratios (ARR) with 95% confidence intervals (CI) for factors associated with external HIV-related stigma. Of 38 919 respondents, 49% (49.8%; 95% CI: 48.6-51.1) were categorised as having higher levels of external HIV-related stigma. Higher levels of HIV-related stigma were significantly associated with those who had secondary level education than those with no education/primary education [ARR = 1.14 (95% CI: 1.05-1.24), p = 0.002], those employed than unemployed [ARR = 1.08 (95% CI: 1.02-1.14), p = 0.006], those in rural areas than urban areas [ARR = 1.15 (95% CI: 1.07-1.23), p<0.001], those who were aware of their HIV status than not aware [ARR = 1.34 (95% CI: 1.12-1.61), p<0.001], those who were HIV positive than HIV negative [ARR = 1.09 (95% CI: 1.02-1.17), p = 0.018], and those with no correct HIV knowledge and myth rejection than their counterparts [ARR = 1.09 (95% CI: 1.03-1.15), p = 0.002]. The findings highlight the need for peer-facilitated HIV-stigma reduction interventions targeting all types of educational institutions and the strengthening of work-based interventions. The findings emphasise the prioritisation of rural informal settings/tribal areas when developing and implementing HIV stigma reduction interventions. The study suggests that stigma reduction should be considered an important component of HIV testing and awareness. Addressing public misconceptions about HIV can mitigate externalised stigma.

Breakfast consumption and associated factors and barriers among school-aged children.

Breakfast provides the energy and nutrition we need to function at best, both mentally and physically. It is also plausible to propose that children's general development is impacted when they skip breakfast. To assess the prevalence of breakfast consumption and associated factors and predictors among public primary school children in Debremarkos Town, Northwestern Ethiopia, 2020. A community-based cross-sectional study was conducted among school-aged children in Debremarkos, Northwest Ethiopia. A multistage random sampling technique was used to select 609 study participants. The children's parents were interviewed using a pretested, structured questionnaire. For the rest of the analysis, SPSS version 20 was used. Logistic regression analysis was performed to assess the factors associated with breakfast consumption. Statistical significance was determined at a p value <0.05. Out of the sampled children, 600 respondents participated in the study, for a response rate of 98.5%. The prevalence of regular breakfast consumption among school-aged children was 67.5%. Higher odds of regular breakfast consumption were found among respondents who were females (AOR = 1.72, 95% CI = 0.118-1.773), those who lived in high-income families (AOR = 7.33, 95% CI = 1.036-8.110), and those who had an educated family (AOR = 13.05, 95% CI = 0.019-13.1). However, lower odds of regular breakfast intake were found among respondents aged 9-12 years (AOR = 0.54, 95% CI = 0.369-0.79). Breakfast is a major health concern for school-aged children in Debremarkos city. Breakfast eating is associated with several factors; the most notable factor is being female, having a high income, and having an uneducated family. Therefore, to prevent children from skipping breakfast, stakeholders must move swiftly.

Factors influencing the third COVID-19 vaccine booster dose acceptance among older adults in northern Thailand

BackgroundCoronavirus disease 2019 (COVID-19) causes more deaths in older adults than in younger adults. Older adults are a vulnerable group with a high need for coronavirus vaccines to decrease the severity of the disease. The aim of this analytical cross-sectional study was to determine the factors influencing third COVID-19 vaccine booster dose acceptance among older adults in northern Thailand.MethodsThe study samples were composed of 2,155 older adults living in Kamphaeng Phet Province, northern Thailand. They were randomly selected by multistage random sampling. Data were collected in a self-administered questionnaire consisting of 7 parts: (1) personal factors, (2) knowledge about COVID-19, (3) perceived susceptibility to COVID-19 infection, (4) perceived severity of COVID-19, (5) perceived benefits of the third COVID-19 vaccine booster dose, (6) perceived barriers to the third COVID-19 vaccine booster dose vaccination, and (7) the third COVID-19 vaccine booster dose acceptance. Data were analyzed via frequency, percentage, mean, standard deviation, and binary logistic regression. All the significance levels were set to 0.05.ResultsThe results indicated that only 28.5% of older adults accepted the third COVID-19 vaccine booster dose. The factors influencing third COVID-19 vaccine booster dose acceptance among older adults included 5 variables. The participants aged ≥ 70 years was 1.37 times (95%CI = 1.12–1.69) greater than those aged < 70 years who accepted the vaccine. Participants who were married were more likely to accept the vaccine by 1.39 times (95%CI = 1.09–1.79) compared with single individuals. Those with underlying diseases tended to accept the vaccine by 1.56 times (95%CI = 1.26–1.92) more than those without underlying diseases. Those who had high perceived benefit from the COVID-19 vaccine possibly accepted the vaccine by 1.50 times (95%CI = 1.10–2.04) more than those with low perceived benefit, and those who had a low perceived barrier to the third COVID-19 booster dose vaccination seemed to accept the vaccine by 1.29 times (95%CI = 1.01–1.52) more than those with a high perceived benefit.ConclusionOlder adults should receive health education regarding the perceived benefit of the COVID-19 vaccine and the perceived barrier to COVID-19 vaccination, especially older adults aged < 70 years, those who are single, and those who are free of underlying diseases.

Measurement model of readiness for online testing of undergraduate students in Thailand’s distance education programs

PurposeThis study aims to develop a model for readiness measurement and to study readiness levels for online testing of undergraduate students in Thailand’s distance education programs.Design/methodology/approachIn total, 870 undergraduate students enrolled in the 2022 academic year of a Thai university were sampled for the study. The samples were divided into two groups: Group 1 comprised 432 students who underwent exploratory factor analysis (EFA) and Group 2 comprised 438 students who underwent second-order confirmatory factor analysis (CFA). Both were multi-stage random samples. Descriptive statistics, item-total correlations (ITCs), coefficient correlations, EFA and second-order CFA were used.FindingsThe readiness for the online testing model comprised 5 factors and 33 indicators. These included self-efficacy (SE) in utilizing technology (nine indicators), self-directed learning (SL) for readiness testing (six indicators), adequacy of technology (AT) for testing (five indicators), acceptance of online testing (AC) (seven indicators) and readiness training for testing (six indicators). The model was congruent with empirical data, and the survey results indicated that students were highly prepared at the “high” level.Practical implicationsThis study disclosed several factors and indicators involved in the readiness for online testing. The university may use these findings in preparing its students for online testing for better achievement.Originality/valueThese findings may serve as a framework for the analysis of the readiness issues for online testing of undergraduate students and also offer guidance to the universities preparing to offer online testing.

Factors Influencing Farmers Purchase Intention toward Insecticides of Rajkot District, India

The present study was conducted to identify the factors influencing farmers purchase intention toward insecticide of Rajkot district. A multi-stage random sampling method was used to select the samples during the actual survey. Total 120 insecticide users were selected randomly from Rajkot district. Principal component analysis was used to identify the factors influencing farmers purchase intention towards insecticide of Rajkot district. The result revealed that six components were product performance, financial support, product specifications, sales team influence, feedback and social influence, significantly impact farmers' purchase intentions for insecticides. The study concludes that multiple factors, including Product performance and farmer experience are the most influential, indicating the importance of reliable and effective products.

Item Analysis of Tool to Examine the Effect of E-Module on the Academic Achievement of Chemistry Students at Secondary Level

This study was conducted to analyze test items by measuring quantitative characteristics (difficulty level and discrimination index). There were 25 MCQ type test items designed by using first two chapters of Chemistry Class 10th. This test was used as a pretest to examine the “Effect of e-module on the Academic Achievement of Chemistry Students at Secondary Level”. Researcher selected 150 students through multistage random sampling from district Gujrat for item analysis. A total of 150 students were used to measure the difficulty index. Researcher arranged the students in descending order and selected 33% high achievers and 33% low achiever by taking a total of 100 students (50 from HEs and 50 from LEs). In this way, 50 top students from high achievers and 50 bottom students from low achievers were selected for Item discrimination. Data were analyzed through descriptive statistics. Findings revealed that 18 items out of 25 were valid. Seven test items (2, 12, 15, 16, 19, 20 and 25) were rejected from the analysis of difficulty index. Out of these seven, difficulty index value for six items was very high (&gt;70). Only one item (19) was difficult and rejected due to the very low value of the difficulty index (&lt; 29). 18 items were retained after necessary revision. Discrimination index of 25 items showed that 18 items were discriminant after the revision of marginal items. It was concluded that 18 items out of 25 were valid based on the Difficulty index and Discrimination index used as a pretest. It was recommended that item analysis is a useful method to ensure the validity and reliability of test items.

Assessment of The Basketball Skills for Secondary School Students in Henan Province, China

Background and Aim: Henan Province is currently prioritizing sports, particularly basketball, offering numerous opportunities for youth to excel. Researchers are focusing on the evolution of basketball education in junior high schools across Henan Province, recognizing the sport's significance within the curriculum and its potential for student development. Materials and Methods: The research study utilized a sample mean group consisting of students at the secondary school level 2 in 10 schools within Henan Province. The sample size of 302 students was determined using Krejcie and Morgan's ready-made sample table. This sample included 157 male students and 145 female students, selected through multi-stage random sampling. Test tool that Drib test, Harrison, Field Goal speed test of Johson and Wall Baunce test of Bunn statistic used parentage valve, Average ( ) Derivation (SD) and T score Results: The assessment of basketball skills among male students in Secondary 2 in Henan Province for the 2023 academic year showed high proficiency. For dribbling in a zigzag, the mean was 25.99 with an SD of 1.63; for shooting a goal quickly, it was 15.10 with an SD of 1.79; and for receiving the ball against the wall, it was 13.39 with an SD of 1.58. For female students, a mean below 17.3 is considered a very high level (T score of 35), while a mean above 24.63 is considered a very low level (T score of 55 or more). Conclusion: Advocates for athletes to prioritize physical training, mental preparation, and skill practice, highlighting the interconnectedness of body condition and mental state in athletic success.

Prevalence and correlates of oral antibiotic use in Canada.

Antimicrobial use (AMU) is a known driver of antimicrobial resistance. Insight into prevalence and correlates of AMU can help identify health inequities and areas for targeted action. To better understand sociodemographic and medical dimensions of AMU in Canada, the Public Health Agency of Canada, in partnership with Statistics Canada, developed a Rapid Response Module questionnaire on self-reported oral antibiotic use, to be administered as part of the 2018 Canadian Community Health Survey (CCHS). To provide data on the proportion of people in Canada that self-report the use of antibiotics and sociodemographic and health factors associated with use. This cross-sectional study used data from the CCHS, a national survey of 24,176 people with a clustered multi-stage stratified random sampling design. In 2018, an antibiotic use module was administered to CCHS participants. Among respondents 18 years and older, 26% reported receipt of at least one oral antibiotic over the past year. Several sociodemographic and health factors had higher adjusted odds of receiving an antibiotic prescription, including those aged 18 years compared to aged 48 years (mean), women compared to men, immigrants compared to non-immigrants (excluding Indigenous), current and former smokers compared to those who have never smoked, and those with comorbidities (asthma, chronic obstructive pulmonary disease, arthritis, heart disease, cancer, bowel disorder and urinary incontinence). Variations in AMU across different key populations and sociodemographic groups highlight the need to improve our understanding of different drivers of AMU and for tailored interventions to reduce inequitable risks of antimicrobial resistance.

Mental Health Literacy Among Urban and Rural Residents of Guangdong Province, China.

The study aims to understanding the mental health literacy level of urban and rural residents in Guangdong Province, the first major province in China, and its influencing factors is crucial. A multi-stage stratified equal-volume random sampling method was adopted in October-December 2022 to select permanent residents aged 18 years and above in Guangdong Province for the questionnaire survey, which consisted of a general demographic information questionnaire and a national mental health literacy questionnaire. Rao-Scott χ²-test with correction based on sampling design, independent samples t-test and binary multivariate logistic regression analysis were performed. A total of 51744 individuals completed the questionnaire, including 31822 urban residents and 19200 rural residents. The rate of achievement of mental health literacy was 13.6% among urban residents, which was significantly higher compared to the rate of 8.6% among rural residents. Logistic regression analysis showed that female, higher education, being mental worker, being a retiree, having a higher monthly household income, maintaining a regular diet, and using electronic products for 2-6hours per day were protective factors for mental health literacy attainment in urban residents, while having chronic diseases, being a smoker and having a history of drinking were identified as risk factors in urban residents. Among in rural residents, married, younger, higher education, being mental worker and using electronic products for 2-6hours per day, maintaining a regular diet, and engaging in regular exercise were protective factors for achieving mental health literacy, while previous smoking was a risk factor. The study revealed a low level of mental health literacy among urban and rural residents of Guangdong Province, with a significant disparity between the two areas. These findings highlight the need for continuing efforts to increase the dissemination of mental health knowledge in rural communities and improve levels of mental health literacy.

Early Maladaptive Schemas, Cognitive Fusion, and Anabolic-Androgenic Steroid Use Attitudes: The Mediating Role of Muscle Dysmorphia in Iran

In recent decades, the interest in having an ideal body in men has caused a pathological tendency to be muscular, followed by a tendency to use anabolic-androgenic steroids (AASs). This study was designed to evaluate the mediating role of muscle dysmorphia in the relationship between early maladaptive schemas and body image-related cognitive fusion with the tendency to use AAS in male athletes. Out of the total number of men referring to fitness clubs in Isfahan, Iran, 474 men were evaluated using a multistage random cluster sampling method. The questionnaires used in this research included the Muscle Dysmorphic Disorder Inventory, Cognitive Fusion Questionnaire—Body Image, Young Schema Questionnaire—Short Form, and Prototype Willingness Model Questionnaire. The results demonstrated that the relationship of AAS use with body image-related cognitive fusion and the three maladaptive schemas with the mediation of muscle dysmorphia is significant. The present study provides significant implications in the discussion of prevention and treatment of AAS addiction.

A Study of School Absenteeism During Menstruation Amongst Adolescent Schoolgirls in An Urban Area of North India

Introduction: WHO has defined adolescence period as the phase of life between childhood and adulthood. This study aimed to estimate the percentage of girls absent from school during menstruation, investigate the underlying causes of this absenteeism, and determine the association between school absenteeism and various factors. Methods: In present community-based study, 473 school going adolescent girls studying in 9th to 12th standards were selected by multistage stratified random sampling method. We selected 3 private and 3 government schools. Adolescent girls were interviewed by pretested, predesigned, semi-structured questionnaire for data collection. Results: The mean age of the students was 16.64 ± 1.4 years. 29.2% participants were absent from school during menstruation. Dysmenorrhea was the most prevalent reason for school absence, quoted by 51(37%) of the participants. In present study positive association between school absenteeism and various socio-demographic factors like the type of school, socioeconomic status, mother's education level, access to hygienic menstrual products and health education was observed. Conclusion: Nearly one-third of the girls were absent in school during menstruation. The main reasons for school absenteeism reported by girls were dysmenorrhea, mother's restrictions, fear of staining cloth and difficulty in changing pads in school.

Irruption of Network Analysis to Explain Dietary, Psychological and Nutritional Patterns and Metabolic Health Status in Metabolically Healthy and Unhealthy Overweight and Obese University Students: Ecuadorian Case.

The association between dietary nutritional patterns, psychological factors, and metabolic health status has not been investigated in university students. There are studies that include numerous variables to test hypotheses from various theoretical bases, but due to their complexity, they have not been studied in combination. The scientific community recognizes the use of Gaussian graphical models (GGM) as a set of novel methods capable of addressing this. To apply GGMs to derive specific networks for groups of healthy and unhealthy obese individuals that represent nutritional, psychological, and metabolic patterns in an Ecuadorian population. This was a quantitative, non-experimental, cross-sectional, correlational study conducted on a sample of 230 obese/overweight university students, selected through a multi-stage random sampling method. To assess usual dietary intake, a Food Frequency Questionnaire (FFQ) was used; to evaluate psychological profiles (anxiety, depression, and stress), the DASS-21 scale was employed; blood pressure and anthropometric data were collected; and insulin levels, lipid profiles, and glucose levels were determined using fasting blood samples. The International Diabetes Federation (IDF) criteria were applied to identify metabolically healthy and unhealthy individuals. Statistical analysis relied on univariate methods (frequencies, measures of central tendency, and dispersion), and the relationships were analyzed through networks. The Mann-Whitney U test was used to analyze differences between groups. In metabolically unhealthy obese individuals, GGMs identified a primary network consisting of the influence of waist circumference on blood pressure and insulin levels. In the healthy obese group, a different network was identified, incorporating stress and anxiety variables that influenced blood pressure, anthropometry, and insulin levels. Other identified networks show the dynamics of obesity and the effect of waist circumference on triglycerides, anxiety, and riboflavin intake. GGMs are an exploratory method that can be used to construct networks that illustrate the behavior of obesity in the studied population. In the future, the identified networks could form the basis for updating obesity management protocols in Primary Care Units and supporting clinical interventions in Ecuador.

Factors associated with contraceptive use among adolescents in three regions of Senegal.

The study aimed to evaluate the use of contraception by adolescents aged 10 to 19 years in three municipalities of Senegal, as well as the associated factors. The study was conducted in 2022 and used a cross-sectional approach. The sample size was 940 participants. Sampling was done using a multistage stratified random sampling method. The chi-square test and logistic regression using R software version 4.2.1 were used to analyze the data. Only 2.2% of adolescents had ever used a contraceptive method. Adolescents aged 15 to 19 years, those residing in Kolda, married adolescents, and those who were aware of family planning were more likely to use family planning methods. We conclude that policymakers in Senegal should implement policies and programmes for improving the reproductive health needs of adolescents in Senegal.

High social capital facilitates the alleviation of psychological distress in breast cancer patients: Insights from a cross-sectional study in Anhui Province, China.

Differences in social capital have been shown to impact psychological distress in cancer patients, but few studies have examined the relationship between social capital and the distress thermometer (DT) in breast cancer patients who have undergone modified radical surgery. To fill this research gap, our study aimed to investigate the association between social capital and the DT among breast cancer patients who underwent modified radical surgery in Anhui Province, China. This cross-sectional study used multi-stage stratified random sampling. Data on demographic characteristics, eight dimensions of social capital, and the DT were collected using a questionnaire. Logistic regression models were subsequently utilized to assess the relationship between social capital and DT, adjusting for confounding factors. A total of 253 participants were included in the final analysis. Results indicated that individuals with higher levels of social capital, including participation in the local community (OR = 3.437; 95% CI: 1.734-6.814), social agency or proactivity in a social context (OR = 69.700; 95% CI: 20.142-241.195), feelings of trust and safety (OR = 26.287; 95% CI: 7.646-90.374), neighborhood connections (OR = 7.022; 95% CI: 3.020-16.236), family and friend connections (OR = 59.315; 95% CI: 17.182-204.760), tolerance of diversity (OR = 9.785; 95% CI: 4.736-20.216), value of life (OR = 65.142; 95% CI: 19.994-212.242), and work connections (OR = 31.842; 95% CI: 12.612-80.397), had higher odds of reporting poor DT scores compared to those with lower levels of social capital. These findings indicate an association between social capital and DT scores in breast cancer patients who have undergone modified radical surgery, suggesting that social capital may play a crucial role in alleviating psychological distress within this community.

Knowledge and Practice Regarding Prevention of Puerperal Sepsis among Postnatal Mothers in Selected Areas of Kamrup (M), Assam

Background: Postpartum period or puerperium is the period following childbirth during which the body tissues especially the pelvic organs revert back approximately to the prepregnant state both anatomically and physiologically. Each mother has to adjust the physical changes in her own body due to involution and lactation as well as puerperal complication which may occur. Title of the study: A study to assess the knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam. Methodology: A quantitative survey approach was adopted to assess the knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam. 81 postnatal mothers were selected using multistage simple random sampling technique from selected areas (Lalganesh, Bank Colony, Adagudam, Sankar Nagar, Kailashpur, Sreebhumi Nagar, Hillview Road, Odalbakra, Gobinda Nagar under Odalbakra MPHC of Dhirenpara zone) Kamrup(M), Assam. A structured interview questionnaire and checklist were used to assess the knowledge and practice of the postnatal mothers regarding prevention of puerperal sepsis

A study to assess the knowledge and practice of women regarding dengue in rural area of Meerut, Uttar Pradesh, India

Background: Dengue affects 390 million people yearly. 70% global disease burden is from Asia. Every fourth person infected with dengue get sick and about one in 20 people infected with dengue develop severe dengue. Aim of this study was to assess the knowledge and practice of women regarding dengue in rural area of Meerut, U.P. Methods: A descriptive survey was done to conduct this study. Multistage random sampling was used to select study area and participants. Data has been collected from 50 participants. Self-developed knowledge questionnaire and checklist was prepared to measure knowledge and practices of people regarding knowledge and practices. Result: Most of the participants were between age group 18-23 years and were homemakers. All participants had previous knowledge about Dengue and source of information was TV/radio/newspaper for most of the participants. In this study 74% of participants has moderately adequate knowledge level, 16% had adequate and 10% had inadequate knowledge level. In regard to practices, 72% participant have satisfactorily practices, 20% had moderately satisfactorily practices and of 8 % participant non satisfactorily practices regarding prevention and management of dengue. Conclusion: Majority of participants had adequate knowledge and satisfactorily practices but still it is needed to organize awareness campaign to disseminate knowledge regarding dengue to community people of all age groups to improve their practices in this regard.

Assessment of the epidemiological risk factors of diabetic and hypertensive patients amongst the adult population

Background: 93 lakh people in India are undergoing diabetes and hypertension medication. It is true that the most important modifiable risk factors for type 2 diabetes and hypertension today are poor diet, cigarette smoking, and insufficient exercise. NCD-related deaths worldwide will increase by 17% by 2025, costing $47 trillion in lost productivity between 2011 and 2030. Methods: 300 diabetics, hypertensive and diabetic with hypertensive patients were selected from 8 urban wards and 8 rural panchayats of Bhopal by multi-stage random sampling. A semi-structured, pretested and validated questionnaire derived from WHO-STEPS survey was used to collect data in terms of socio-demographic variables, behavioural risk factors measurement and physical measurements. Mean and standard deviations were calculated for quantitative data, frequency and proportions were calculated for qualitative data. Chi-square value was calculated and p value less than 0.05 was considered statistically significant. Results: The mean age was 46.55±2.17 years. DBP found to be 3% more than 39% of males have systolic BP ≥140 mm of Hg. 33.6% fall under obese-I category. Current tobacco smokers, current alcohol consumption, heavy alcohol use, salt intake &gt;5 gm/day, BMI ≥30 (obese-II) was significantly associated with hypertension. Conclusions: The study’s findings indicate that the alarmingly high occurrence of risk factors for diabetes and hypertension among adults need immediate attention. This indicates the need for an extensive screening and awareness campaign to identify undetected cases in the community and to offer early treatment and continuous follow-up to prevent consequences.

Long-term exposure to low-level ozone and the risk of hypertension: A prospective cohort study conducted in a low-pollution region of southwestern China

BackgroundThe current evidence regarding the association between long-term exposure to ozone (O3) and hypertension incidence is limited and inconclusive, particularly at low O3 concentrations. Therefore, our research aims to investigate the potential link between long-term O3 exposure and hypertension in a region with low pollution levels. MethodsFrom 2010 to 2012, we conducted a cohort prospective study by recruiting nearly 10,000 attendees through multistage cluster random sampling in Guizhou Province, China. These individuals were followed up from 2016 to 2020, and 5563 cases were finally included in the analysis. We employed a high-resolution model with both temporal and spatial accuracy to estimate the maximum daily 8-h average O3 and utilized annual average O3 concentrations for three exposure periods (2009_10, 2007_10, 2005_10) as the exposure indicator. Time-dependent covariates Cox regression model was exerted to estimate the hazard ratios (HRs) of hypertension incidence. Generalized linear model was employed to assess the association between O3 and systolic, diastolic, pulse, and mean arterial pressure. The dose-response curve was explored using a restricted cubic spline function. Results1213 hypertension incidents occurred during 39,001.80 person-years, with an incidence density of 31.10/1000 Person Years (PYs). The average O3 concentrations during the three exposure periods were 66.76 μg/m3, 67.85 μg/m3, and 67.21 μg/m3, respectively. Per 1 μg/m3 increase in O3 exposure was associated with 11 % increase in the incidence of hypertension in the single-pollution model, and the association was more pronounced in Han, urban, and higher altitude areas. SBP, PP, and MAP were increased by 0.619 (95 % CI, 0.361–0.877) mm Hg, 0.477 (95 % CI, 0.275–0.679) mm Hg, 0.301 (95 % CI, 0.127–0.475) mm Hg, respectively. Furthermore, we observed a nonlinear exposure-response relationship between O3 and hypertension incidence. ConclusionsLong-term exposure to low-level O3 exposure is associated with an increased risk of hypertension.

Prevalence of Trachoma and Associated Factors among Children Aged 1–9 Years in Kombolcha District, East Hararge, Oromiya Regional State, Ethiopia, 2021

&amp;lt;i&amp;gt;Introduction:&amp;lt;/i&amp;gt; Trachoma, caused by the bacterium Chlamydia trachomatis, remains a significant public health concern and the leading infectious cause of blindness worldwide. In 2021, trachoma was endemic in 42 countries, primarily located in Africa, and accounted for 80% of the global burden of blindness due to an infectious disease. Despite the availability of effective prevention strategies and treatment, trachoma continues to be a major issue in certain regions, including Ethiopia. &amp;lt;i&amp;gt;Objectives: &amp;lt;/i&amp;gt;This study aimed to assess the prevalence and identify factors associated with trachoma among children aged 1-9 years in rural communities of the Kombolcha district, East Hararge zone, Oromia Regional State, Ethiopia.&amp;lt;i&amp;gt; Methods: &amp;lt;/i&amp;gt;A cross-sectional study design was employed, involving children aged 1-9 years in rural communities. A multistage random sampling method was utilized to select 622 study participants. Data were collected through face-to-face interviews using a structured questionnaire, which was pretested on 5% of the sample size. After data cleaning and entry into Epi Info version 7.1, data were exported to SPSS version 23 for analysis. Variables with a p-value &amp;lt; 0.20 in bivariate binary logistic regression were included in a multivariate binary logistic regression model to identify factors associated with trachoma. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated to evaluate the strength of associations at a p-value &amp;lt; 0.05.&amp;lt;i&amp;gt; Results: &amp;lt;/i&amp;gt;The overall prevalence of active trachoma among children aged 1-9 years was 7.55%. Of the affected children, 83% exhibited trachomatous inflammation follicular (TF), 11% had trachomatous inflammation intense (TI), and 6% had both TF and TI. The prevalence ranged from 2.7% in children aged 1-4 years to 10.4% in children aged 5-9 years. In the multivariate analysis, factors significantly associated with the presence of active trachoma in the study population included: * Households with unprotected water sources (AOR = 0.32, 95% CI: 0.15-0.67) * Regular towel usage (AOR = 8.03, 95% CI: 2.18-29.6) * Not using soap to wash the face (AOR = 4.53, 95% CI: 2.13-9.63) * Family history of eye problems (AOR = 4.76, 95% CI: 2.19-10.35) &amp;lt;i&amp;gt;Conclusion and Recommendation: &amp;lt;/i&amp;gt;The overall prevalence of active trachoma in the study area was 7.55%. While this prevalence is below the WHO threshold for mass drug administration (MDA) (&amp;gt;10%), it remains a significant public health concern. The findings highlight the need to implement the WHO-endorsed SAFE strategy, which focuses on surgery, antibiotics, facial cleanliness, and environmental improvement, to effectively prevent and control trachoma. Additionally, improving the overall living conditions of the community through coordinated efforts is essential in addressing the factors associated with the disease.

Exploring the Components of Multicultural Competence among Pre-Service Teacher Students in Thailand: An Approach Utilizing Confirmatory Factor Analysis.

The aim of this study is to examine the components of multicultural competence among pre-service teacher students in Thailand and to develop and assess the reliability of a model of multicultural competence for pre-service teacher students in Thailand. Multistage stratified random sampling was utilized to recruit 600 pre-service teacher students from undergraduate education programs at the Faculty of Education in Thailand. Data were collected through self-report questionnaires. The data analysis employed descriptive statistics and second-order confirmatory factor analysis (CFA). The findings indicate that multicultural competence among pre-service teacher students comprises three components: cultural awareness, cultural knowledge, and personal skills. Furthermore, this study identified that the model of multicultural competence among pre-service teacher students demonstrated good fit indices for the modified model (χ2 = 30.902, df = 21, p-value = 0.0753, χ2/df = 1.472; root mean square error of approximation (RMSEA) = 0.028; standardized root means square residual (SRMR) = 0.013; Tucker-Lewis index (TLI) = 0.996; comparative fit index (CFI) = 0.999). Based on these findings, effective teaching in diverse environments necessitates a thorough understanding of multicultural competence.